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NGOs, the developing world, and the philanthropy industrial complex

Amy WalshInternational Emergency Medicine FellowAugust 16, 2012

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Drag picture to placeholder or click icon to addThe Flip Side of

Foreign Aid

+A few disclaimers…

Almost all individuals working in aid organizations clearly want to do good

The problem comes when people think that good intentions alone are enough

We need to evaluate the outcomes of what we are doing, rather than accepting that we want badly to help and that’s good enough

+How I became jaded…

I arrived in Haiti, three weeks after the earthquake

Our clinic was set up in the courtyard of the nursing school

No group knew what the other groups were doing, so other groups would send us PICU type patients despite our having the same resources as they did to care for them.

The UN was driving around in air-conditioned white Land Cruisers, eating lobster dinners at the country club with scotch and cigarettes

+Objectives

Recognize the dire results of unintended consequences and poor planning

Discuss how our stereotypes of the developing world color our evaluation of their need for our help

Recognize that US, UN, and large NGO policies are designed with self-interest and self-preservation in mind.

Discuss how we can improve our provision of international health care and international development assistance

+Unintended consequences

In The Road to Hell, by Michael Marin, he had been planning to start a well program in the desert and met with an expert, who he expected to praise his plan

The expert told him, “During rainy season this well will provide extra water for the nomads. It will allow them to have bigger herds. When the dry season comes, the nomads will begin to migrate toward your well or any permanent source of water. They will arrive with larger herds and begin to denude the land closest to the well…As soon as it is more than a day’s walk from the water to the grass, the cows will die. “ He explained goats and sheep will die after a two day walk, camels after a week, and after the camels the people will die.

+Unintended consequences

Polman argues that “sowing horror to reap aid and reaping aid to sow horror” is “the logic of the humanitarian era”

For example: Christian aid groups set up “redemption” programs to buy the

freedom of Sudanese slaves, which drove up market incentives for slavers to take more captives

In Ethiopia and Somalia in 1980s-1990s, politically instigated, localized famines attracted food aid that allowed governments to feed their own armies while they further destroyed and displaced targeted population groups

Aid fortified Khmer Rouge killers lived in camps on the Thai-Cambodia border, enabling them to visit ten years of war, terror, and misery upon Cambodians

And Rwanda as well. The genocidaires continue to wage campaigns of extermination and rape to this day.

+Unintended consequences

Bob Geldof led Band Aid and Live Aid to raise money for Ethiopia, raising more than $104 million.

This money was spent not in compliance with conditions laid down by a donor government, but rather by the Ethiopian regime.

Aid workers arrived with the money, and food aid was used as bait to lure starving villagers into camps. They were held there awaiting deportation to state farms. A life of forced labor lay ahead.

+Unintended consequences

The government army took a share of the food aid and even requisitioned trucks from aid organizations to move people out.

About 600,000 people were moved and 100,000 died.

When asked about that figure, Geldof felt the fact that aid was available was more important than the circumstances in which it was delivered.

+Unintended consequences

There is no regulation of NGOs, and anyone with enough money can show up at a crisis and pitch their flag.

Vacationing American doctors turned up in Sierra Leone, sponsored by their churches and performed life-threatening and life taking operations without proper aftercare